| Entity Name: | CULPEPPER-HARRELL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Aug 1956 (68 years ago) |
| Document Number: | 195273 |
| FEI/EIN Number | 590785111 |
| Address: | 120 North 9th Street, Palatka, FL, 32177, US |
| Mail Address: | 120 North 9th Street, Palatka, FL, 32177, US |
| ZIP code: | 32177 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518004316 | 2007-01-31 | 2007-10-31 | 610 ZEAGLER DR, PALATKA, FL, 321773811, US | 610 ZEAGLER DR, PALATKA, FL, 321773811, US | |||||||||||||||||||||||||
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| Phone | +1 386-325-2096 |
| Fax | 3863120466 |
Authorized person
| Name | MRS. PATTY D LONG |
| Role | VP |
| Phone | 3866983737 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | PH6820 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | R9807 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Fletcher JAMES R | Agent | 120 North 9th Street, Palatka, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| FLETCHER JAMES R | President | 120 North 9th Street, Palatka, FL, 32177 |
| Name | Role | Address |
|---|---|---|
| Fletcher JAMES R | Secretary | 120 North 9th Street, Palatka, FL, 32177 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000135263 | YOUR HOME MEDICAL | ACTIVE | 2021-10-08 | 2026-12-31 | No data | 120 N 9TH STREET, PALATKA, FL, 32177 |
| G15000112438 | YOUR HOME MEDICAL | EXPIRED | 2015-11-04 | 2020-12-31 | No data | PO BOX 608, CRESCENT CITY, FL, 32112 |
| G15000016477 | YOUR HOME MEDICAL PALATKA | EXPIRED | 2015-02-16 | 2020-12-31 | No data | 610 ZEAGLER DRIVE, PALATKA, FL, 32177 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
